Mandating Transparent Fee Schedules from Health Insurers for Medical Procedures
Ministry of HealthSpeakers
Summary
This question concerns Mr Yip Hon Weng’s inquiry into mandating transparent fee schedules from health insurers and implementing stipulated timeframes for processing medical claims. Minister Ong Ye Kung explained that mandatory fee schedules are not feasible due to varying procedural complexities and that such schedules are typically published by healthcare providers rather than insurers. He highlighted that the Ministry of Health provides fee benchmarks for common conditions and updates past bill sizes annually to help patients make informed decisions. Additionally, while insurers can publish committed panel fees from doctor contracts, the Ministry of Health already monitors and publishes insurance service indicators. Finally, Minister Ong Ye Kung noted that claims processing durations and pre-authorisation turnaround times for Integrated Shield Plan insurers are already publicly available on the Ministry’s website.
Transcript
40 Mr Yip Hon Weng asked the Minister for Health (a) whether the Ministry can consider mandating transparent fee schedules from health insurers for medical procedures to help patients make informed decisions when seeking private care; (b) if so, how will the Ministry ensure that such fee schedules will be in the interest of patients amidst the competing interests of the insurers and doctors; and (c) whether the Ministry can implement a stipulated timeframe to process the claims and payouts for these fee schedules.
Mr Ong Ye Kung: Medical procedures do not have mandatory fee schedules as this depends on the patient's condition and complexity of the procedure. Any fee schedule published will also be done by the healthcare provider and not the insurer. That said, doctors may enter into contractual agreements with Integrated Shield Plan (IP) insurers to provide services at committed panel fees, which insurers can consider publishing.
On the Ministry of Health's (MOH's) part, it has developed private hospital fee benchmarks for about 30 common conditions to provide a reference of reasonable fees. Past bill sizes of common conditions can also be found on MOH's website, which is updated annually. Patients are encouraged to refer to them when choosing a healthcare provider.
MOH also monitors selected service indicators for private insurance. The claims processing duration for IP claims with payouts and pre-authorisation turnaround time for scheduled treatment for each insurer are published on MOH's website.